Depression

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.

Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.

Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.

Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.

Bipolar disorder is different from depression, but it is included in this list because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.

During a depression, you may experience the following psychological symptoms:

• You feel down and have no interest in anything.
• You don’t enjoy things and have no energy.
• You feel guilty and worthless: "I don’t matter."
• You feel empty: "I don’t feel anything anymore."
• You often feel anxious, hopeless, and powerless: "No matter what I do, nothing will change."
• You cry a lot without feeling relieved, or you want to cry but can’t.

Depression can also cause one or more physical symptoms:

• You feel exhausted.
• You have no appetite, causing significant weight loss. Or you eat a lot and gain weight.
• You sleep very little and poorly, or you sleep excessively.
• You have little or no sexual desire.
• You experience a dry mouth.
• You suffer from unexplained pain, chest pressure, headaches, or back pain.
• You often feel dizzy and have trembling hands.
• You experience heart palpitations.

• You get angry and irritated quickly.
• You often think about death, for example: "I’d rather be dead."
• You worry a lot, often about the same things.
• You have trouble concentrating and frequently forget things.
• You find it difficult to make decisions.
• You respond and speak slowly and have trouble thinking clearly.
• You struggle to get anything done or, on the contrary, can’t sit still for a moment.